AI + Healthcare: Improving Value-Based Care & Financial Resilience

In this Bright Spots in Healthcare episode, host Eric Glazer brings together an all-star panel of leaders who are reshaping the future of Medicaid and social care. Our guests include: Laurie Stradley, CEO, Impact Health Lori Andrade, EVP, Health Equity Alliance of Long Island (HEALI) Joneigh Khaldun, MD, President & CEO, Public Health Accreditation Board (PHAB) Evan Jones, Chief Strategy Officer, Vircho Together, they explore: How community-based organizations (CBOs) are evolving into trusted healthcare partners Practical strategies for bridging healthcare and social care at scale The role of technology, data, and community health workers in building sustainable Medicaid networks Real-world success stories—from disaster recovery in North Carolina to integrated care models in New York and beyond You’ll hear how leaders are overcoming compliance, billing, and operational challenges while keeping people, not just systems, at the center of care. If you’re looking for bright spots you can replicate to drive innovation, equity, and efficiency in Medicaid, this episode is packed with lessons and inspiration. Panelist Bios: https://www.brightspotsinhealthcare.com/events/doubling-down-on-medicaid-innovation-in-a-post-obbb-world/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. https://www.brightspotsinhealthcare.com/wp-content/uploads/2025/09/Episode-Guide_Doubling-Down-on-Medicaid-Innovation.pdf  Resources: 2025 HRSN Innovations Learning Lab Conference, Oct. 23-24, 2025, Asheville NC Guided by Impact Health and the WNC Health Policy Initiative, participants will navigate hands-on workshops, build teams through peer networking, and discover practical paths to success beyond Medicaid—all while connecting with trailblazing experts from across the country. Learn more and register here - https://ihorg.jotform.com/251884444887979 Check out PHAB’s new podcast In Service of Health with Dr. Joneigh Khaldun, which explores what it really takes to build healthier communities. Learn more and subscribe here - https://in-service-of-health.podcastpage.io/ Thank you to our Episode Partner, Vircho: Vircho partners with health plans, Government, and Community Care Hubs to connect healthcare with the social needs that impact health. Their tools make it easier to deliver community-based services efficiently and improve outcomes for the people we all serve. To learn more, visit https://vircho.com/ Schedule a meeting with Evan Jones, Chief Strategy Officer, Vircho: To dive deeper into how social care networks are optimizing capacity and outcomes, schedule a meeting with Evan Jones. Reach out to [email protected] to schedule the meeting. About Bright Spots Ventures: Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.   We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.

What does it really take to challenge the status quo in healthcare, and win? Dr. Imamu “Mu” Tomlinson, CEO of Vituity and author of Less Than One Percent: How Disruptors Defy the Odds, joins host Eric Glazer to share hard-won lessons on leadership, resilience, and breaking barriers. In this energizing conversation, Mu discusses: How to turn “you can’t” into the fuel that drives innovation. Why being disagreeable, optimistic, and relentless are the core traits of true disruptors. Lessons healthcare can borrow from sports icons like Steph Curry and leaders in entertainment. Why moments of victory - not defeat - are the best opportunities to spark lasting change. You’ll come away with a fresh perspective on leadership, culture, and how to build teams that defy expectations and achieve more. About Dr. Imamu (Mu) Tomlinson: Imamu Tomlinson, MD, MBA, is the Chief Executive Officer at Vituity, a physician-led and -owned multispecialty partnership. With decades of clinical leadership and practice management experience, Dr. Tomlinson brings deep operational and clinical knowledge to foster Vituity’s mission to be at the heart of better care. In his role, Dr. Tomlinson oversees Vituity’s 500+ communities, focusing on clinical and cultural integration, and strategies that improve patient satisfaction and drive operational efficiency. Since his appointment as CEO in 2017, Vituity has doubled its footprint. Additionally, during his tenure, Dr. Tomlinson formalized two disciplines within Vituity to support improved patient care: an innovation team, including the appointment of the organization’s first Chief Innovation Officer, and a community impact initiative. He also champions physician engagement initiatives, including fellowship programs and innovation grants, to further empower Vituity’s healthcare providers to deliver exceptional care and collaborate across the care continuum. Prior to Vituity, Dr. Tomlinson was the Chief of Staff for the Adventist Health Central Valley Network, where he continues to practice as an emergency physician. He previously served as Medical Director for Adventist Health's Hanford and Selma Emergency Departments. At Adventist Health, he spearheaded an effort to create the network's Department of Emergency and Diagnostic Medicine and later served as the department’s chair.  Outside of his work at Vituity, Dr. Tomlinson is devoted to making a difference in his local community through the 24/7 Foundation, which works with kids in the Central Valley Youth to inspire mental toughness, athletic competition, and resilience through basketball.  Dr. Tomlinson is the author of Less Than One Percent: How Disruptors Defy the Odds. In this book, he thoughtfully explores the lives of those who dare to defy the odds and disrupt a world of contradictions. Through vivid narratives and deep insights, he reveals powerful strategies for challenging the status quo and driving transformative change.  Order your copy today. About Bright Spots Ventures: Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation. We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.

Artificial intelligence is no longer just a buzzword, it’s a practical tool transforming how healthcare organizations prepare for the future. From evaluating and pricing risk with greater accuracy to identifying rising-risk members and strengthening long-term financial strategies, AI is reshaping the very foundations of forecasting in healthcare. In this episode, leaders from Florida Blue, Premera Blue Cross, Blue Shield of California, and Prealize Health share how they’re applying AI across actuarial, clinical, and data science domains to optimize decisions, improve outcomes, and drive organizational sustainability. In this episode, you’ll learn: How health plans are evaluating and scaling AI models to improve accuracy in forecasting and underwriting Real-world examples of AI identifying rising-risk populations and transforming engagement strategies Why “next best action” models are becoming central to member engagement and population health How generative AI and workflow optimization are streamlining operations and reducing costs What it takes to embed AI into financial planning, provider contracting, and long-term ROI strategies Panelists: Romilla Batra, MD, MBA, SVP & Chief Medical Officer, Premera Blue Cross Ratnik Gandhi, Senior Director, AI, Florida Blue Emily Allred, Senior Director & Actuary, Large Group Pricing, Blue Shield of California Dean Noble-Tolla, PhD, Chief Product & Analytics Officer, Prealize Health Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here.

Learn how AI is already working to close the member engagement gap, transforming intent into impact, personalizing care at scale, and creating the connected experiences members now expect. Leaders from Highmark Health, Ovatient, Cigna, and League share proven strategies, bright spots, and lessons learned in applying AI to drive measurable outcomes, lower costs, and improve the member experience. In this episode, you’ll learn: How AI is turning digital intent into meaningful health actions Real-world examples of personalized engagement that improved outcomes and savings Why the future of digital health is shifting from mobile-first to AI-first What it takes to build a scalable, purpose-built AI platform for healthcare How payers and providers can unite around the member with AI-powered engagement Panelists: Ian Blunt, VP Advanced Analytics, Highmark Health Michael Dalton, Founder & CEO, Ovatient Charles DeShazer, MD, Former Chief Quality Officer, The Cigna Group         Andrew Dubowec, Chief Growth Officer, League       Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here. Resources Here’s the podcast Eric Glazer referenced during the show: Acquired/ACQ2 Episode: How is AI Different Than Other Technology Waves? (With Bret Taylor and Clay Bavor), August 18, 2025 Thank you to League for supporting this episode. League is the leading healthcare consumer experience platform, reaching more than 40 million people around the world and delivering the highest level of personalization in the industry. Payers, providers, and consumer health partners build on League’s platform to deliver high-engagement healthcare solutions proven to improve health outcomes. Learn more at www.league.com. How to Engage: Chat with Us: Share your thoughts with Producer Jessica Tenzer at [email protected]  

With member engagement driving everything from Star Ratings to care gap closures, health plans are rethinking how they connect with members—pairing rich data with human-centered strategies to create real moments of influence. In this episode, we explore how payers are: Combining multiple assessments, social risk data, and AI to build actionable member profiles Using empathy-driven outreach and concierge-style service to build trust Leveraging real-time insights to engage members at the right moment Aligning cross-functional teams to accelerate innovation and close gaps Turning clinical, social, and behavioral signals into measurable quality gains Whether you focus on Stars, Medicaid quality, or member experience, you’ll walk away with practical strategies to engage more effectively and improve outcomes. Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here. Download the Episode Notes and KPI’s: Get the moderator notes and the Key Points of Interest from the episode.  Download here. Icario Client Summit Information: Additional details about the Icario Summit - Moments of Influence - taking place October 21-23, 2025, can be found here. Thank you to Icario for supporting this episode. Icario is a leading health action platform that helps payers connect with members in ways that drive measurable results. By combining behavioral science, data-driven personalization, and omnichannel outreach, Icario motivates members to complete critical health actions—closing gaps in care, improving Star Ratings, and reducing avoidable costs—while delivering an experience that feels relevant, human, and engaging. Learn more at www.icariohealth.com. How to Engage: Chat with Us: Share your thoughts with Producer Nicole Roberts at [email protected]  

With adherence measures playing a major role in Star Ratings, Medicare Advantage plans are rethinking how they engage members—moving beyond transactional reminders to personalized, story-driven content that inspires real behavior change. In this episode, leaders from Zing Health, Horizon Blue Cross Blue Shield of New Jersey, and SmartStory share how they're using storytelling, data, and behavioral insights to: Improve medication adherence and close gaps at scale Design culturally relevant, human-centered messaging Translate member engagement into measurable Star Rating gains Avoid common pitfalls in content strategy and execution Whether you lead pharmacy, Stars strategy, or member engagement, this discussion offers actionable insights to improve performance heading into the 2026 Star Ratings year. Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. Download here. here. Thank you to SmartStory for supporting this episode. SmartStory delivers secure, app-like digital experiences that help health plans improve medication adherence, member satisfaction, and quality performance—without requiring downloads or logins. Learn more at  https://www.smartstory.com/ How to Engage: Chat with Us: Share your thoughts with Producer Vekonda Luangaphay at [email protected]  

Episode Description: In this episode, League, Vori Health, and Fitzroy International unpack how healthcare organizations are rethinking growth, partnerships, and go-to-market strategies in a rapidly shifting environment. Learn how leading innovators are: Designing scalable, digitally enabled experiences to meet evolving consumer expectations Adapting sales and billing models amid policy and reimbursement uncertainty Attracting long-term, “patient capital” to fuel innovation in mission-driven organizations From enterprise partnerships to nimble, virtual-first care models, this discussion delivers fresh perspectives and actionable strategies for leaders navigating transformation across health plans, health systems, and digital health. How to Engage: Chat with Us: Share your thoughts with Head of Production Strategy and Operations, Haritha Krishnarathnam at [email protected]

Episode Description: How can healthcare leaders expand access and improve equity at scale without further burdening overstretched systems? In this Bright Spots in Healthcare episode, senior leaders from leading provider organizations explore how remote-first, tech-enabled primary care models are transforming access for diverse and underserved populations. Through real-world examples, clinical, innovation, and strategy experts will highlight how they’re leveraging data, team-based care, and smart technology to: Expand access to historically marginalized communities Improve care continuity and build patient trust Reduce avoidable utilization and enhance system efficiency Deliver sustainable, equitable outcomes at scale Panelists: Michael Cui, MD, Associate Chief Medical Informatics Officer, Rush University Medical Center Amanda Parsons, MD, MBA, Vice President, Clinical Management, Healthfirst Emily Young, MBA, President, Tufts Medicine Integrated Network, Tufts Medicine Gabriella Lawrence, Senior Director, Clinical Solutioning, TytoCare Download the Episode Guide: Summarizing key insights and speaker highlights, this guide is your companion to the discussion. Download it to follow along and take away actionable strategies. Thank you to TytoCare for supporting this episode. TytoCare is transforming primary care with a smart, remote-first approach that connects patients and clinicians to deliver equitable, efficient healthcare, anytime, anywhere. Learn more here: https://www.tytocare.com How to Engage: Chat with Us: Share your thoughts with Producer Jessica Tenzer at [email protected]  

Episode Description: In this episode, Atlantic Health System, Intermountain Health, and Navina explore how AI is transforming value-based care by boosting financial resilience and improving outcomes. Learn how these organizations are: Enhancing risk adjustment and closing care gaps Reducing administrative burden through AI-augmented workflows Equipping teams with real-time insights to drive performance under VBC models From virtual medical assistants to smarter financial planning, this discussion offers actionable strategies for leaders across clinical, operational, and financial roles. Download the Episode Guide: Summarizing key insights and speaker highlights, this guide is your companion to the discussion. Download it to follow along and take away actionable strategies. Thank you to Navina for supporting this episode. Navina helps physicians thrive in value-based care with an AI-powered platform that turns data into actionable clinical insights. Learn how they’re enabling smarter decisions, better care, and less burnout at www.navina.ai. How to Engage: Chat with Us: Share your thoughts with Producer Vekonda Luangaphay at [email protected]  

Scaling AI across a healthcare system takes more than just good technology—it requires effective governance, operational focus, and the right data foundation. In Part 2 of our conversation with Kiran Mysore, Chief Data & Analytics Officer at Sutter Health, he explores how Sutter is operationalizing AI across its 24 hospitals and hundreds of care sites. You’ll hear: How the AI Council—a cross-functional governance body—ensures alignment, safety, and momentum What makes the “Sutter Navigator” platform a game-changer for operational visibility Why “speed of business” and “speed of foundation” must be balanced to move fast and responsibly How Sutter is applying lessons from finance and retail to transform healthcare This episode is a masterclass in AI implementation at scale—perfect for health system leaders, innovators, and data executives alike.       About Kiran Kiran is the Chief Data Analytics Officer at Sutter Health, a leading not-for-profit healthcare network in America. With over 25 years of experience, Kiran has been instrumental in driving digital transformation and leveraging data and AI to generate business value across various sectors, including healthcare, technology, and consulting.    Before joining Sutter Health in September 2023, Kiran held significant roles at prestigious organizations such as Medtronic, GE, Apple, and St. Jude Medical. His expertise includes optimizing operations, developing real-time insights, and modernizing technology infrastructures. Known for his commitment to fostering data-driven cultures and championing diversity and ethical practices in data, Kiran’s leadership at Sutter Health focuses on making data and insights meaningful to improve healthcare outcomes, operational efficiency, and patient care. His work exemplifies the transformative power of technology in advancing healthcare. About Bright Spots Ventures Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation. We help healthcare leaders discover what’s working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the “bright spots” in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.